Summary

Lassa fever is present in West Africa. It is a haemorrhagic fever that is spread through rat excrement. Human to human cases have been reported, but these have been confined to areas of very poor sanitation. The risk to travellers is restricted to those staying in areas of very poor sanitation, or those nursing infected patients.

Summary

Infected mosquitoes spread malaria. The species that spreads malaria tend to bite between dusk and dawn.

Distribution and Transmission

Malaria is a disease that affects Africa, South and Central America, Asia and the Middle East. Because mosquitoes prefer humid conditions and need fresh water to breed there is often a seasonal increase noted, particularly in those areas that experience heavy rainfall.

Prevention

Prevention of mosquito bites is the first stage of defence. This includes wearing long sleeve shirts and trousers, using a good mosquito repellent, using mosquito nets while sleeping and being especially careful at dawn and dusk. Malaria tablets are also recommended - there are several different prevention medications that are recommended depending on the countries which you travelling through. Please feel free to contact us so we can work out exactly what you need for your travels - should you require prescription tablets we are able to organise this for you.

Signs and Symptoms

The incubation period ranges from 2 weeks - 35 days. The disease presents itself with a range of symptoms that may include:

	Fever
	Headache and muscle pain
	Malaise (tiredness)
	Rigors (shivering) and extreme sweating
	Diarrhoea, abdominal pain
	Dry cough
	Jaundice
	Anaemia

Emergency Treatment

If you develop a fever while travelling or having returned from your trip it is essential to seek medical advice. Emergency treatment should be carried if you are travelling to remote areas where medical facilities are unavailable.

Distribution and Transmission

Lyme disease is transmitted by tick bites. The ticks live on a range of small animals like rodents and birds and larger animals such as deer and dogs.

It is present in Europe (particularly through Scandinavia) and North America (particularly the eastern coast).

Signs and Symptoms

Following an infected bite a rash can occur and spread. This happens 2-6 weeks after the initial bite. Long term symptoms can include neurological (nerve) problems, meningitis, arthritis and dementia.

Recommendation for Travellers

Avoid Tick bites and seek medical treatment especially if you are in a risk area.

Treatment

Antibiotics can be used to treat the illness.

Validity - 9 Years          Price - £ 65

  
Disease Fact File   

Summary

Varicella is a highly infectious disease caused by the Herpes Varicella Zoster Virus. This acute infection is most common in children, therefore most adults are immune. Once contracted, varicella is usually quite mild in children, but can be quite severe in adults, particularly with women during pregnancy. Having the disease usually creates life-long immunity, although it is possible to get varicella again.

Distribution and Transmission

Varicella is present in all countries throughout the world. Varicella is transmitted and spread through personal contact and/or droplets passed on through coughing, sneezing or spluttering. Varicella can be contracted throughout the whole year with peaks identified in spring and early summer.

Signs and Symptoms

The incubation period of varicella is 10-21 days. First it appears as flat red splotches, which become raised and may resemble small pimples. The rash then develops into small blisters, called vesicles, which are very fragile. As the vesicles break, the sores become pustular and form a crust - the crust is made of dried serum, and not true pus. Itching is severe in the pustular stage. They often appear on the scalp and in the mouth, and then spread to the rest of the body, but they may begin anywhere. They are most numerous over shoulders, chest and back. There may be only a few sores, or there may be hundreds. The blistery sores last approximately 1 week. Varicella is contagious 2 days before the rash appears, lasting until the blisters crust over.

Recommendation for Travellers

This vaccine is not routinely recommended for travellers, unless adults and adolescents have negative immunity.

Additional Information

The Varicella vaccination costs £65

Validity -  1-3 Years          Price - £ 70

  
Disease Fact File  

Distribution and Transmission

Tick-Borne Encephalitis is transmitted to humans via the bite of an infected Tick. It has also been known to be transmitted by the ingestion of unpasteurised milk from infected animals, especially goats. The Virus is maintained in nature by small mammals, domestic livestock and in certain species of birds.
You are more likely to contract Tick-Borne Encephalitis in early summer months when ticks are most active. At risk areas include European Russia, Austria, Hungary, The Balkans, Czech Republic, Slovakia and Scandinavia. The incidence of Tick-Borne Encephalitis can also be found in far eastern parts of the former USSR, extending across into China.

Signs and Symptoms

Tick-Borne Encephalitis is a flu-like illness, with symptoms progressing 7-14 days after being bitten. Symptoms include sudden onset of fever, headache, nausea and photophobia, which could possibly progress to neck stiffness, convulsions and an altered mental state. Complications include meningitis, encephalitis, and muscular paralysis.

Recommendation for Travellers

The Tick-Borne Encephalitis vaccination is recommended for those most likely to be exposed to tick bites, such as; long term travellers, campers, forest walkers, foresters and agriculturalists.
Most importantly, avoid tick bites by wearing appropriate clothing, such as tucking trousers into socks or footwear and using appropriate insect repellent. In the event of being bitten by a tick, remove promptly and seek medical advice.

Additional Information

The Tick-Borne Encephalitis vaccine is given in 2 separate doses 1-3 months apart and costs £70 per injection.

Validity - 10 Years          Price £ 25

  
Disease Fact File   

Summary

Polio is predominantly contracted through contaminated food and water, although acute infections may be passed on through the nasopharyngeal droplets.

Distribution and Transmission

Polio has impacted significantly on developing countries resulting in many people being crippled. Effective vaccination has virtually eradicated the disease, with the exception of Asian and African developing countries.

Prevention

It is recommended that travellers to countries endemic with polio vaccinate themselves against polio

Signs and Symptoms

The illness has an incubation period of 7-14 days. With 90% of cases there are no symptoms - sometimes resulting in lifetime immunity. A mild flu like illness with a fever presents in 8% of cases, and the remaining 2% of cases, symptoms include paralysis, bladder dysfunction, impaired swallowing, breathing and speech (bulbar poliomyelitis) which may be fatal.

Validity - 11 Years          Price £ 30

  
Disease Fact File   

Distribution and Transmission

Signs and Symptoms

Recommendation for Travellers

All travellers visiting epidemic or endemic areas such as Asia, Africa and South America should ensure they are fully immunised against measles, mumps and Rubella. Infants under 6 months of age travelling to these areas or where there is a current outbreak should receive the MMR vaccination.

Additional Information

The MMR vaccination costs £30

Validity - 1 Year          Price - £15

  
Disease Fact File   

Summary

Inactivated influenza vaccine (split virion) BP helps to protect you against influenza. Influenza is a viral infection that may have serious complications, particularly in some vulnerable groups of people. The active ingredients in this vaccine are three strains of killed influenza virus which the World Health Organisation has advised are going to be most common this year ( 2005/2006 ). This vaccine cannot give you influenza and will protect for one year. Influenza is a disease caused by many different types of virus and can spread rapidly, especially in homes or institutions where it is very easy to catch and spread the infection. The greatest risk of catching influenza is during the cold months between October and March. Influenza is present every year even when epidemics or outbreaks are not reported.

Validity - 10 Years          Price - £ 30

Disease Fact File   

Distribution and Transmission

Hepatitis B is present in many parts of the world. It is endemic in the Pacific regions, Southest Asia and West Africa. The disease is common in South and Central America the Middle East and India and present but less common throughout Australia, North America and Europe.

Hepatitis B is passed from person to person via infected body fluid. This can result from injuries where there is blood-blood contact, use of infected medical equipment, from mother to the unborn child and also via sexual transmission.

Signs and Symptoms

Sometimes people will not experience any symptoms once exposed to Hepatitis B. For those people who do develop the acute illness symptoms can include: mild fever and joint pain, a rash and jaundice. Hepatitis B can lead to permanent liver damage and cancer.

Recommendation for Travellers

Vaccination is recommended for people who fall into the following categories:

If you are staying in medium to high risk areas for periods greater than 3 months, or if you are a frequent visitor to these areas
People with medical conditions who may need medical treatment while traveling
Health care workers
Children who will be attending school with locals in areas with poor hygiene
Sexually at risk, or those people using needles

The usual recommended schedule for vaccination is as follows:

Option A

1st Hepatitis B shot £30

2nd Hepatitis B shot £30 - 1 month after the first vaccination

3rd Hepatitis B shot £30 – 6 months after the first vaccination

This should provide 5 - 10 years protection

Option B

1st Twinrix (Hep B and Hep A) £60

2nd Twinrix £60 – 1 month after the first vaccination

3rd Twinrix £60 – 6 months after the first vaccination

This course will provide 5 - 10 years protection for Hepatitis B and 20-30 years protection for Hepatitis A

Validity - 10-20 Years          Price - £ 60

  
Disease Fact File   

Summary

It is possible to vaccinate against Hepatitis A and B with a course of three injections of 'Twinrix' over a six month period. This course is given like the Hepatitis B Regime:

1st Twinrix - £60
2nd Twinrix - £60 - 1 month after the 1st vaccination
3rd Twinrix - £60 - 6 months after the first vaccination

This course will provide 10 years protection for Hepatitis B and 20-30 for Hepatitis A.

For further information about Hepatitis A and B please refer to the specific sections.